Contents
Cal Poly Pomona

Mental Health and Substance Abuse

Go to the Kaiser Permanente home page

1-800-464-4000

www.kaiserpermanente.org

Group #5701-00

Following are excerpts from the Evidence of Coverage (E.O.C.) Booklet, displayed for your convenience. Please refer to the E.O.C. for details or contact the plan directly.

Mental Health

Inpatient - Treatment of an acute phase of mental health condition during a certified confinement in a participating hospital.

No Charge- up to 30 days per calendar year

Outpatient - Evaluation, crisis intervention, and treatment for conditions, which are subject to significant improvement through relatively short-term therapy.

$20/visit- up to 20 visits per calendar year

Substance Abuse

Inpatient - Hospitalization as medically necessary to remove toxic substances from the system.

No Charge

Outpatient - Evaluation, crisis intervention, and treatment for conditions which are subject to significant improvement through relatively short-term therapy.

$10/visit - up to 20 visits per calendar year

 

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